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GIM - Awesome

General questions GIM

who should NOT get live vaccines pregnant, CD4<200, transplant, immunosupressants
Live vaccines (4) varicella, polio, yellow fever, MMR - live yellow pollo (polio, chicken pox) with mumps on skin
druzen macular degeneration
old person who can't recognize faces macular degeneration
cotton wool spots areas of ischemia; DDx: hypertension, diabetes, HIV, severe anemia or thrombocytopenia, hypercoagulable states, connective tissue disorders, viruses, and others.
neovascularization on fundoscopy exam, what is dx and what is tx? DM proliferative retinopathy, tx with laser
hard exudates on fundoscopy cholesterol deposits
AV nicking on fundoscopy areas of veins that are narrowed on either side of the retinal arteries because arteries are so big - indicates HTN
silver wiring on fundoscopy veins that are so engorged that they look brighter, indicating HTN
dendritic ulcer on flourescein exam Herpes keratitis
‘Hollenhorst’ plaque on fundscopy platelet/fibrin/cholestorol embolus. Resulting in an infarct
Pale-centered hemorrhage on fundoscopy Roth spot, bacterial endocarditis.
WBCs in anterior chamber after cataract surgery endophthalmitis - eye emergency! Infection of anterior eye layers by virus or bacteria
bilateral medial joint-space narrowing, subchondral sclerosis, and small osteophytes osteoarthritis
active hip abduction intensifies the pain or in those in whom the examination reveals pain and tenderness over the bursa trochanteric bursitis
gold standard study to diagnose nephrolithiasis noncon CT
who gets screening for AAA? Men Ages 65 to 75 Years who Have Ever Smoked
how to treat painful diabetic neuropathy low-dose tricyclic antidepressant and topical application of capsaicin cream
what test will predict fall risk in an elderly person who falls backward? pull test - examiner gives forceful tug backward, enough to displace pt center of gravity. Pt should make a quick compensatory backward step. Patient with postural instability (cardinal feature of parkinsonism) will not take step but instead fall back.
Dix Hallpike with nystagmus lasting 20-30 seconds vestibular vertigo (not central)
What test to use to screen for HIV? HIV antibody enzyme immunoassay (EIA)
who gets HIV screening HIV screening for all persons between the ages of 13 and 75 years at least once and that those with risk factors undergo annual testing
when to use HIV Western blot? Western blot assay is the confirmatory test for HIV infection and should only be used to confirm that a reactive EIA is a true positive and not a false-positive result.
when to do HIV nucleic acid amplification testing in the window period when pt has acute HIV sx's but EIA is not positive yet
how to tx acute urticaria Combination H1- and H2-antihistamines are the first-line therapy for patients with acute urticaria - cetirizine, ranitidine, and diphenhydramine
elderly man, preop for hip surgery, atypical chest pain not associated with exertion 1-2y, h/o COPD - what to do for preop w/u needs stress test because intermediate probability with old age and atypical chest pain. Need dobutamine stress because he can't exercise with COPD and need for hip replacement
how to treat restless legs syndrome pramipexole or ropinirole (dopamine agonist); opiates
how to diagnose Periodic limb movements of sleep and treat polysomnography; tx with pramipexole or ropinirole
All adults aged 18 years and older should be screened for hypertension; screening every how many years those with blood pressure below 120/80 mm Hg. 2
how often should BP screening be for people with systolic blood pressures of 120 mm Hg to 139 mm Hg and diastolic blood pressures of 80 mm Hg to 89 mm Hg yearly
who should be screened for osteoporosis all women age 65 years or older and also in younger women with an elevated fracture risk (alcoholism, corticosteroid use for more than 3 months, low body mass, current tobacco use, dementia, or use of anticonvulsants)
rotator cuff tendinitis pain between 60 to 120 degrees of abduction, positive Neer (pain with his right arm in full flexion) and Hawkins sign,
treatment for moderate menstrual bleeding Medroxyprogesterone acetate for 10 to 21 days. progesterone will typically act to stabilize the endometrium and stop uterine blood flow.
If heavy menstrual bleeding, orthostatic, and dizzy - how to treat? What are the risks of the treatment? ntravenous estrogen. Parenteral conjugated estrogens are approximately 70% effective in stopping the bleeding entirely. Pulmonary embolism and venous thrombosis are complications of intravenous estrogen therapy.
Created by: christinapham



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